Editing Attention deficit hyperactivity disorder (section)

====Guidelines====
[[Medical guideline|Guidelines]] on when to use medications vary by country. The United Kingdom's [[National Institute for Health and Care Excellence]] recommends use for children only in severe cases, though for adults medication is a first-line treatment.<ref name="NICE_2019">{{Cite book |author=National Institute for Health and Care Excellence |url=https://www.nice.org.uk/guidance/ng87/ |title=Attention deficit hyperactivity disorder: diagnosis and management |publisher=National Guideline Centre (UK) |year=2019 |isbn=978-1-4731-2830-9 |series=NICE Guideline, No. 87 |location=London |pages= |oclc=1126668845 |access-date=9 January 2021 |archive-url=https://web.archive.org/web/20210112035209/https://www.nice.org.uk/guidance/ng87/ |archive-date=12 January 2021 |url-status=live}}</ref> Conversely, most United States guidelines recommend medications in most age groups.<ref name="CADDRA">{{cite web |title=Canadian ADHD Practice Guidelines |url=http://www.caddra.ca/cms4/pdfs/caddraGuidelines2011Introduction.pdf |url-status=live |archive-url=https://web.archive.org/web/20210121222344/https://www.caddra.ca/cms4/pdfs/caddraGuidelines2011Introduction.pdf |archive-date=21 January 2021 |access-date=4 February 2011 |work=Canadian ADHD Resource Alliance}}</ref> Medications are especially not recommended for preschool children.<ref name="NICE_2019" /><ref name="NICE 2009" /> Underdosing of stimulants can occur, and can result in a lack of response or later loss of effectiveness.<ref>{{cite journal |vauthors=Stevens JR, Wilens TE, Stern TA |title=Using stimulants for attention-deficit/hyperactivity disorder: clinical approaches and challenges |journal=The Primary Care Companion for CNS Disorders |volume=15 |issue=2 |date=2013 |pmid=23930227 |pmc=3733520 |doi=10.4088/PCC.12f01472}}</ref> This is particularly common in adolescents and adults as approved dosing is based on school-aged children, causing some practitioners to use weight-based or benefit-based off-label dosing instead.<ref>{{cite web |vauthors=Young JL |url=http://www.medscape.org/viewarticle/734449_print |title=Individualizing Treatment for Adult ADHD: An Evidence-Based Guideline |date=20 December 2010 |website=Medscape |archive-url=https://web.archive.org/web/20220508225446/https://www.medscape.org/viewarticle/734449_print |archive-date=8 May 2022 |url-status=live |access-date=8 May 2022}}</ref><ref>{{cite web |vauthors=Biederman J |url=http://www.medscape.com/viewarticle/464377_print |title=New-Generation Long-Acting Stimulants for the Treatment of Attention-Deficit/Hyperactivity Disorder |date=21 November 2003 |website=Medscape |archive-url=https://web.archive.org/web/20220508225829/https://www.medscape.com/viewarticle/464377_print |archive-date=8 May 2022 |url-status=live |access-date=8 May 2022 |quote=As most treatment guidelines and prescribing information for stimulant medications relate to experience in school-aged children, prescribed doses for older patients are lacking. Emerging evidence for both methylphenidate and Adderall indicate that when weight-corrected daily doses, equipotent with those used in the treatment of younger patients, are used to treat adults with ADHD, these patients show a very robust clinical response consistent with that observed in pediatric studies. These data suggest that older patients may require a more aggressive approach in terms of dosing, based on the same target dosage ranges that have already been established&nbsp;– for methylphenidate, 1–1.5–2 mg/kg/day, and for D,L-amphetamine, 0.5–0.75–1 mg/kg/day.... <br />In particular, adolescents and adults are vulnerable to underdosing, and are thus at potential risk of failing to receive adequate dosage levels. As with all therapeutic agents, the efficacy and safety of stimulant medications should always guide prescribing behavior: careful dosage titration of the selected stimulant product should help to ensure that each patient with ADHD receives an adequate dose, so that the clinical benefits of therapy can be fully attained.}}</ref><ref>{{cite journal |vauthors=Kessler S |title=Drug therapy in attention-deficit hyperactivity disorder |journal=[[Southern Medical Journal]] |volume=89 |issue=1 |pages=33–38 |date=January 1996 |pmid=8545689 |doi=10.1097/00007611-199601000-00005 |s2cid=12798818}}</ref>